Aetna's Ongoing Commitment to Special Needs Plans in 2025
Aetna has confirmed its plan to offer a range of Medicare plans in 2025, including Special Needs Plans (SNPs). These plans are designed for individuals with specific health needs. For 2025, Aetna is expanding its Dual Eligible Special Needs Plans (D-SNPs) and Chronic Condition Special Needs Plans (C-SNPs) to increase access to tailored care.
Understanding Medicare Special Needs Plans
Special Needs Plans are Medicare Advantage (Part C) plans for people with particular conditions or circumstances. They offer standard Medicare Advantage benefits plus additional support for specific needs. Aetna offers two main types:
- Chronic Condition Special Needs Plans (C-SNPs): For those with severe chronic conditions like diabetes or chronic heart failure. These plans provide benefits and programs to help manage the specific condition.
- Dual Eligible Special Needs Plans (D-SNPs): For individuals eligible for both Medicare and Medicaid. These plans coordinate benefits and provide additional support for healthcare costs.
Aetna's 2025 D-SNP and C-SNP Expansions and Features
For 2025, Aetna is introducing new D-SNP PPO options in several states and counties and expanding its C-SNP offerings in select areas for conditions such as diabetes and chronic heart failure. Eligibility for C-SNPs requires a doctor's verification of the qualifying condition.
Key Benefit Enhancements for 2025 SNPs:
Aetna has integrated multiple benefit cards into a single Aetna Medicare Extra Benefits Card for 2025. This card provides an allowance for eligible health items, including OTC products and healthy foods. Additionally, most D-SNPs will include a fall prevention benefit, offering an allowance for home safety items. Aetna is also consolidating its stand-alone Prescription Drug Plans (PDPs) into one plan, SilverScript® Choice (PDP).
Comparing Aetna's 2025 C-SNP and D-SNP
| Feature | Chronic Condition Special Needs Plan (C-SNP) | Dual Eligible Special Needs Plan (D-SNP) |
|---|---|---|
| Eligibility | Requires diagnosis with a qualifying chronic condition (e.g., diabetes, chronic heart failure). | Requires eligibility for both Medicare and Medicaid. |
| Benefit Focus | Enhanced benefits and care management for specific chronic conditions. | Coordinates Medicare and Medicaid benefits; provides extra assistance for dual-eligible members. |
| Medicaid Status | Eligibility is not dependent on Medicaid status. | Requires concurrent eligibility for Medicaid benefits. |
| Special Enrollment | Special Enrollment Period (SEP) triggered by a qualifying diagnosis or condition. | New monthly integrated care SEP for those with full Medicaid aligning coverage with the same insurer. |
| Primary Care | Access to networks specializing in chronic care, potentially including specialized providers. | Typically coordinates care through a Primary Care Provider (PCP), but varies by plan. |
Enrollment Information for Aetna SNPs in 2025
Availability of Aetna SNPs varies by location. You can check for plans in your area using the ZIP code tool on the Aetna website.
- Check Eligibility: Confirm you meet the criteria for a C-SNP (with physician verification) or a D-SNP (dual-eligible status).
- Compare Plans: Review plan benefits and networks on the Aetna website or with an agent. The Annual Enrollment Period (AEP) is a key time to enroll, but Special Enrollment Periods (SEPs) may also apply.
- Understand the New D-SNP SEP: For those with full Medicaid, a new monthly integrated care SEP in 2025 allows switching to a D-SNP with the same insurer that manages your Medicaid. You can find more details on the CMS Website.
- Enroll: Enrollment can be done online, by phone, or with assistance from an agent.
Conclusion
For 2025, Aetna is offering and expanding its C-SNP and D-SNP options. The introduction of benefits like the integrated Extra Benefits Card highlights Aetna's focus on supporting members with specific health needs through specialized and coordinated care.
